This project would entail a multi-stakeholder effort to design and implement financial incentives and rewards to speed the adoption of The Leapfrog Group's recommended hospital patient safety practices: computerized physician order entry; evidence-based hospital referrals for select high-risk conditions and procedures; and staffing intensive care units with trained specialists. The Leapfrog Group is a consortium of more than 110 large private and public health care purchasers who buy health benefits for approximately 32 million Americans. Building on volunteer work during 2002 by Leapfrog's incentives and rewards work group consisting of hospital, health plan, physician, consumer and purchaser representatives, as well as actuarial support from Towers Perrin, and project management and health benefits contracting guidance from General Electric Company, Leapfrog would devise a plan for implementing financial incentive or reward pilots in approximately three U.S. healthcare markets where purchasers are making a concerted effort to implement Leapfrog's patient safety initiatives. Leapfrog members are committed to rewarding hospitals for their efforts, however most purchasers need significant help with making high-level design plans operational before they can begin. This planning project would build multi-stakeholder collaboration, further the design of incentive and reward concepts to test at the regional level, and set the stage for an evaluation to test the effectiveness of incentives or rewards in actual health care markets.